Neuro_MR_TSpine: 18 M, chronic granulomatous disease, immunosuppressed, fever.

CLINICAL HISTORY: 15 years of age, Male, Evaluate for abscess versus osteomyelitis at T2.


The T2 vertebral body demonstrates STIR hyperintense signal abnormality and enhancement. There is a ventral epidural collection at the T2 level measuring a maximum sagittal cross-section of 14 x 3 mm (series 3: Image 10). There is involvement of the right T2-T3 neural foramen. There is cord displacement posteriorly. CSF is seen around the entire thoracic cord. No cord signal abnormality. No significant disk involvement is seen. The edema and enhancement extends inferiorly along the paravertebral region anteriorly causing pleural enhancement with right lung component difficult to exclude.

There is also marked prevertebral soft tissue swelling associated with the T2 vertebral lesion with multiple rim-enhancing fluid collections consistent with abscesses measuring up to 2.5 cm in size in the prevertebral soft tissues. This process extends from the C7 level to the T4 level. The extent of tissue necrosis suggests fungal etiology.

There is also mild STIR hyperintense signal at the T7 vertebral body. No soft tissue changes are visualized.

The thoracic vertebral body heights and alignment are maintained. The thoracic spinal cord is preserved and morphology and signal intensity.


1.  T2 vertebral body edema and enhancement compatible with osteomyelitis. There is also abscess formation in the prevertebral soft tissues. Additional ventral epidural collection as detailed above. These findings are concerning for an infectious process and the extensive tissue necrosis suggests fungal etiology.

2.  Additional signal abnormality within the T7 vertebral body concerning for a second area of osteomyelitis. No associated paravertebral soft tissue changes are seen at this level.

(Multifocal osteomyelitis)

Accession: CL27388549

Study description: LPCH MRI T SPINE W AND WO CONTRAS 72157